Individual provider · Type 1 NPI
John Michael Blanco Mata, NP
Nurse Practitioner · Prescott, AZ
Practice location
3250 Gateway Blvd Ste 112
Prescott, AZ 86303-6856
Mailing address
PO Box 522
Humboldt, AZ 86329-0522
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 267971 (AZ) |
| Adult Health Nurse Practitioner | 363LA2200X | 267971 (AZ) |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 267971 (AZ) |
| Nurse Practitioner Primary | 363L00000X | 267971 (AZ) |
| Gerontology Nurse Practitioner | 363LG0600X | 267971 (AZ) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
3 other providers at this address
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About NPI 1639871247
John Michael Blanco Mata, NP's National Provider Identifier is 1639871247, issued on Mar 20, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Prescott, AZ. The record was last updated on Jan 31, 2024.